Question 1

A client is prescribed a hypertonic intravenous solution.Administration of this solution will most likely cause which manifestation to occur?

Accepted Answer

Hypertonic solutions have a higher concentration of solutes than the surrounding fluid, causing water to move from the interstitial space to the vascular space, leading to an increased fluid volume in the vasculature which can result in an increase in blood pressure. Therefore, the plasma will have more solutes than the interstitial fluid.

Question 2

A client has a serum sodium level of 157 mEq/L.Which area of assessment is the priority?

Accepted Answer

The priority area of assessment in this case is the level of consciousness. A high serum sodium level can lead to neurological symptoms such as confusion, seizures, and coma. Therefore, the nurse should monitor the client's level of consciousness closely to detect any changes and intervene as necessary.

Question 3

The nurse is reviewing a client's lab values,which indicate normal serum osmolality.Which intravenous solutions will not cause a fluid shift in this client?

Accepted Answer

Isotonic solutions have the same concentration of solutes as the body's extracellular fluid and will not cause fluid shifts in clients with normal serum osmolality. Colloids, hypertonic solutions, and hypotonic solutions all have different concentrations of solutes compared to the body's extracellular fluid and can cause fluid shifts.

Question 4

The nurse is reviewing the tonicity of the different intravenous fluids on the medical-surgical unit in preparation for an in-service presentation.Which fluids are considered to be isotonic and appropriate in the treatment of fluid loss due to a surgical procedure? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is reviewing the tonicity of...

Question 5

A nurse is evaluating a client's serum osmolality.Which solute is not factored into this value?

Accepted Answer

Serum osmolality is a measurement of the concentration of solutes in the blood, typically expressed in milliosmoles per kilogram (mOsm/kg). Factors that contribute to serum osmolality include sodium, urea, glucose, and other dissolved particles. Water, however, is not a solute and therefore is not factored into the calculation of serum osmolality.

Question 6

A client diagnosed with diabetes insipidus is suffering from severe hypernatremia.The nurse anticipates the use of which type of intravenous solution?

Accepted Answer

The use of a hypotonic crystalloid solution (such as 0.45% sodium chloride or 0.2% sodium chloride) is indicated to treat hypernatremia in clients with diabetes insipidus. This is because these solutions have a lower sodium concentration than the client's serum, causing water to move into the cells and diluting the excess sodium in the bloodstream. Hypertonic solutions would worsen the hypernatremia by increasing the serum sodium concentration, while isotonic solutions would not effectively lower the sodium level. Albumin may be used in some cases of hypovolemia, but would not be the first choice for hypernatremia in diabetes insipidus.

Question 7

A client is prescribed a transfusion of fresh frozen plasma (FFP).The nurse plans care based on the knowledge that the transfusion will complete which process?

Accepted Answer

Fresh frozen plasma is used to replace clotting factors and other blood components in patients with multifactor deficiency states, such as liver disease, massive hemorrhage, or disseminated intravascular coagulation. It is not used to rehydrate or dehydrate cells, and it does not cause fluid to shift out of the intravascular space.

Question 8

When a nurse administers a hypotonic intravenous solution to a client,how will the water move?

Accepted Answer

When a hypotonic solution is administered intravenously, it decreases the osmolarity of the plasma, making it less concentrated than the interstitial fluid. This difference in concentration causes water to move by osmosis from the plasma compartment (where the hypotonic solution is added) to the interstitial compartment (where the concentration of solutes is now relatively higher), in an attempt to equalize the osmotic pressure across the compartments.

Question 9

A client with long-standing hepatic cirrhosis might receive which intravenous solution to correct hypoproteinemia?

Accepted Answer

Patients with hepatic cirrhosis often experience hypoproteinemia due to decreased albumin production by the liver. The best choice would be to provide them with intravenous albumin to correct the deficiency. The other options listed would not directly address the hypoproteinemia.

Question 10

When planning care,the nurse anticipates that which client will most likely require intravenous fluid replacement?

Accepted Answer

Shock is a medical emergency that requires immediate intravenous fluid replacement to restore circulating blood volume and prevent organ damage. Clients with congestive heart failure and SIADH may require fluid restriction instead of fluid replacement, and a minor burn may not necessarily require intravenous fluid replacement.

Question 11

A nurse is caring for a client with a serum potassium level of 6.9 mEq/L.When planning care,which body system will be most profoundly affected by this value?

Accepted Answer

The cardiovascular system will be most profoundly affected by a serum potassium level of 6.9 mEq/L. High levels of potassium in the blood can cause cardiac arrhythmias, leading to a decrease in cardiac output and potential cardiac arrest.

Question 12

The nurse is caring for a client with severe electrolyte imbalances that have occurred as a result of kidney failure.The nurse knows that this client is at risk for which disorders as a result of this electrolyte imbalance? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

Severe electrolyte imbalances, particularly with sodium, potassium, and calcium, can lead to fluid retention, muscle spasms, and an increased risk of fractures. High cholesterol and depression are not directly related to electrolyte imbalances resulting from kidney failure.

Question 13

A client has a severe fluid and electrolyte imbalance.The nurse is aware that in order for the body to move large molecules and molecules with electrical charges,which two processes are required?

Accepted Answer

The answer of A client has a severe fluid and...

Question 14

A client has a serum potassium of 2.5 mEq/L.While reviewing the client's medical administration record,the nurse suspects that which medication might have contributed to this imbalance?

Accepted Answer

Hydrochlorothiazide is a medication that is known to cause a decrease in potassium levels, which can lead to hypokalemia. Metoprolol, aspirin, and acetaminophen do not typically cause changes in potassium levels.

Question 15

The nurse is aware that body fluids are exchanged between which compartments?

Accepted Answer

Body fluids are exchanged between the intracellular (within cells) and extracellular (outside cells, including interstitial fluid and blood plasma) compartments. This exchange is crucial for maintaining homeostasis in the body.

Question 16

When treating fluid imbalances,which is the ultimate goal of care?

Accepted Answer

The ultimate goal of care when treating fluid imbalances is to diagnose and correct the underlying cause of the disorder. Simply administering intravenous fluids, maintaining normal vital signs, or keeping clients normothermic may provide temporary relief, but does not address the actual problem. Therefore, the best option is to focus on diagnosing and correcting the root cause of the fluid imbalance.

Question 17

A client is prescribed 100 mL of 3% normal saline solution received 1,000 ml of 3% normal saline.Which is the priority assessment for this client?

Accepted Answer

The priority assessment for this client would be blood pressure as administering a large volume of fluid can lead to fluid overload, potentially causing an increase in blood pressure. Skin integrity, capillary refill, and coagulation profile are not directly related to the administration of fluids in this scenario.

Question 18

A nursing instructor asks a student at what point it is appropriate to treat hyponatremia.Which response by the student is accurate?

Accepted Answer

The normal range for sodium (Na+) in the blood is 135-145 mEq/L. Hyponatremia is defined as a serum sodium concentration below 135 mEq/L. Treatment is typically initiated when levels fall below 130 mEq/L, as symptoms may become severe below this level. Therefore, option A is the most accurate choice.

Question 19

The nurse is caring for a group of clients on a medical-surgical unit.For which clients would the nurse anticipate the need for intravenous fluid therapy to correct fluid depletion? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is caring for a group...

Question 20

A client has vomited several times and continues to be nauseated.To correct mild hypovolemia,the nurse plans to complete which intervention?

Accepted Answer

Administering an isotonic crystalloid would be the best intervention to correct mild hypovolemia as it will replace the lost fluid volume and help maintain electrolyte balance. Option A may not be enough to correct the hypovolemia, and option C may exacerbate it by diluting electrolyte concentrations. Option D may also exacerbate electrolyte imbalances and may not be necessary for mild hypovolemia.

Quiz 33: Pharmacotherapy of Fluid Imbalance,electrolyte,and Acid-Base Disorders